Fax Reservation Form

Yes, I would like to vacation at Heart Beat!

Instructions: Fill in this form, print it, then fax it to Valerie at(876) 957-0069

Please provide your name and address information:

Name:

Address1:

Address2:

Zip code: COUNTRY:

Telephone: Fax:

Please select the accomodation you would prefer:

Main House:      Duplex Cottage:      Studio Apartment:      Pillar Room:

Please indicate the days you plan to stay:

Expected Arrival: Expected Departure:

Please bill my:

Master Card:        Visa:        American Express:

Account Number: Exp. Date:

Name on Card: Guest Signature:

Note:  A service charge of 3% for Visa and Master Card and 4% for American Express will be added to your bill.   A certified/manager's cheque may be posted by mail to confirm a reservation instead of a credit card payment.   Balance is due on arrival.

For Questions, click here to email Valerie at Heart Beat.

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